Organization
SUNDANCE HOME DIALYSIS LLC
Active
Organization
SUNDANCE HOME DIALYSIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK R NAIL (BUSINESS MANAGER)
(512) 826-3696
Entity
Organization
Contact information
Practice address
1809 PRECINCT LINE RD, HURST, TX 76054-3132
(817) 840-5191
(817) 840-5192
Mailing address
4375 BOOTH CALLOWAY RD STE 208, NORTH RICHLAND HILLS, TX 76180-8362
(817) 512-5902
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
05/06/2021
Last updated
08/30/2021
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